AccountId: 011433970860
ContactId: 437c801a-19c2-4c27-920b-0e16e5fda3f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242610 ms
Total Talk Time (AGENT): 86139 ms
Total Talk Time (CUSTOMER): 72197 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/437c801a-19c2-4c27-920b-0e16e5fda3f9_20250306T18:37_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from provider's office to check on a claim status.
[AGENT][POSITIVE] Good afternoon
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that. And the member's policy number?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] 023-268 02 M as in Mike L as in Lima followed with the number 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Remembers name
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] Sure. The date of service is on.
[CUSTOMER][NEUTRAL] Mhm. [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] It's $11,320 and even.
[AGENT][NEUTRAL] So I'm showing that we received the claim. Well, first, can you verify the name of the provider's office on the claim, I'm sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's HCF Florida Kindal Hospital.
[AGENT][NEUTRAL] OK, I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 347.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 92.
[AGENT][NEUTRAL] 87
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] What is the possible way to submit the primary insurance explanation of benefit?
[AGENT][NEUTRAL] Um, you can fax it, you can mail it, or you can send it electronically.
[CUSTOMER][NEUTRAL] Mhm. Can I get the mailing address to send it?
[AGENT][NEUTRAL] Sure. So it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] On the
[CUSTOMER][NEUTRAL] The zip code is [PII]. Am I right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And can I get the fax number to send it?
[AGENT][NEUTRAL] 877
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there any timely filing limit to submit the
[CUSTOMER][NEUTRAL] You will be
[AGENT][NEUTRAL] Um, there's a timely filing limit you can, um,
[AGENT][NEUTRAL] File the claim at any time as long as the policy is active.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Thank you. Can I get the.
[CUSTOMER][NEUTRAL] Call reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Could you please spell your first name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you and, and thank you for time and assistance. Have a nice day and bye for now.
[AGENT][POSITIVE] You're very welcome, [PII]. Thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Right.